Hongliang Yan, Pengfei Li, Cuiping Jin, Yumin Shang, Hongmei Wang, Shenjia Liu, Fuling Ma
In this selected cohort of postpartum women with SUI and coexisting cystocele and mixed-type pelvic floor dysfunction, positive CST, greater BND, and reduced rapid contraction capacity were associated with poorer sexual function, whereas longer postpartum period was associated with better sexual function. These exploratory findings are specific to this population and require validation in broader cohorts.
INTRODUCTION AND HYPOTHESIS: The objective was to investigate the association of pelvic floor muscle (PFM) function and pelvic floor anatomy with sexual function in postpartum women with stress urinary incontinence (SUI) at 6-12 months postpartum.
METHODS: All participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12; higher scores indicate better sexual function). PFM function was evaluated using the Glazer protocol, and pelvic floor anatomy by dynamic pelvic floor ultrasound. Clinical characteristics including parity, mode of delivery, and cough stress test (CST) results were collected. Spearman correlation and multiple linear regression analyses were performed to identify factors associated with PISQ-12 scores.
RESULTS: The mean age of participants was 33.58 ± 4.57 years, with a mean postpartum period of 8.37 ± 2.21 months. In Spearman correlation analysis, PISQ-12 scores correlated negatively with pre-rest state (rs = -0.333, p < 0.001), post-rest state (rs = -0.302, p < 0.001), bladder neck descent (BND; rs = -0.251, p = 0.003), and urethral rotation angle (rs = -0.243, p = 0.004), and correlated positively with rapid contraction maximum values (rs = 0.189, p = 0.027). Multiple linear regression analysis revealed that positive CST (B = -5.984, p < 0.001), greater bladder neck descent (B = -0.195, p = 0.012), and lower rapid contraction capacity (B = 0.094, p < 0.001) correlated with poorer PISQ-12 scores in this sample. Longer postpartum period correlated with better PISQ-12 scores (B = 0.613, p < 0.001), explaining 54.7% of the variance (adjusted R2 = 0.519).
CONCLUSIONS: In this selected cohort of postpartum women with SUI and coexisting cystocele and mixed-type pelvic floor dysfunction, positive CST, greater BND, and reduced rapid contraction capacity were associated with poorer sexual function, whereas longer postpartum period was associated with better sexual function. These exploratory findings are specific to this population and require validation in broader cohorts.